Healthcare Provider Details

I. General information

NPI: 1184604563
Provider Name (Legal Business Name): THOMAS SEXTON D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 02/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 HURFFVILLE CROSS KEYS RD
TURNERSVILLE NJ
08012-2453
US

IV. Provider business mailing address

435 HURFFVILLE CROSS KEYS RD
TURNERSVILLE NJ
08012-2453
US

V. Phone/Fax

Practice location:
  • Phone: 856-218-5634
  • Fax: 856-218-5664
Mailing address:
  • Phone: 856-218-5634
  • Fax: 856-218-5664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMB06948800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number25MB06948800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: